Short take home messages :

1) Bayetta is good for T2 but has to be injected
2) Januvia is good for T2 , works along the lines of Bayetta but can be
taken as a pill  :)
3) The price of Januvia is a bit "steep"  :(

Bayetta is a synthetic incretin mimetic
Bayetta is made by the pharmaceutical industry
Bayetta was discovered in a lizard
It mimics an incretin like GLP-1 , Glucagon like protein 1

GLP-1 :
1) Stimulates Insulin secretion
2) Inhibits Glucagon secretion
3) Delays Gastric emptying

Bayetta is a protein so it has to be injected

The new drug , sitagliptin or Januvia, is an inhibitor of the enzyme that
breaks GLP-1 down (DPP-4 = Di Peptydyl Peptidase-4)
Sitagliptin is a small synthetic molecule made by the pharmaceutical
industry (Merck)

http://www.glucagon.com/mk-0431.htm

So sitagliptin will protect the GLP-1 you produce yourself from breakdown by
DPP-4

Article :

Diabetologia. 2006 Sep 26

Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin as
monotherapy in patients with type 2 diabetes mellitus.

AIMS/HYPOTHESIS: The aim of this study was to assess the efficacy and safety
of sitagliptin (MK-0431) as monotherapy in patients with type 2 diabetes
mellitus and inadequate glycaemic control (HbA(1c) >/=7% and </=10%) on
exercise and diet. METHODS: A total of 521 patients aged 27-76 years with a
mean baseline HbA(1c) of 8.1% were randomised in a 1:2:2 ratio to treatment
with placebo, sitagliptin 100 mg once daily, or sitagliptin 200 mg once
daily, for 18 weeks. The efficacy analysis was based on an
all-patients-treated population using an analysis of covariance, excluding
data obtained after glycaemic rescue. RESULTS: After 18 weeks, HbA(1c) was
significantly reduced with sitagliptin 100 mg and 200 mg compared with
placebo (placebo-subtracted HbA(1c) reduction: -0.60% and -0.48%,
respectively). Sitagliptin also significantly decreased fasting plasma
glucose relative to placebo. Patients with higher baseline HbA(1c) (>/=9%)
experienced greater placebo-subtracted HbA(1c) reductions with sitagliptin
(-1.20% for 100 mg and -1.04% for 200 mg) than those with HbA(1c) <8%
(-0.44% and -0.33%, respectively) or >/=8% to 8.9% (-0.61% and -0.39%,
respectively). Homeostasis model assessment beta cell function index and
fasting proinsulin:insulin ratio, markers of insulin secretion and beta cell
function, were significantly improved with sitagliptin. The incidence of
hypoglycaemia and gastrointestinal adverse experiences was not significantly
different between sitagliptin and placebo. Sitagliptin had a neutral effect
on body weight. CONCLUSIONS/INTERPRETATION: Sitagliptin significantly
improved glycaemic control and was well tolerated in patients with type 2
diabetes mellitus who had inadequate glycaemic control on exercise and diet.

PMID: 17001471

hth
Gys